title: How is informed consent related to emotions and empathy? An exploratory neuroethical investigation.
abstract: BACKGROUND
  Informed consent is crucial in daily clinical practice and research in medicine and psychiatry. A recent neuroethical investigation explored the psychological factors that are crucial in determining whether or not subjects give consent. While cognitive functions have been shown to play a central role, the impact of empathy and emotions on subjects' decisions in informed consent remains unclear.
  
  
  OBJECTIVE
  To evaluate the impact of empathy and emotions on subjects' decision in informed consent in an exploratory study.
  
  
  METHODS
  Decisional capacity and informed consent to a subsequent imaging study were evaluated with the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR). Empathy and emotion recognition were measured with the Multifaceted Empathy Test (MET) and the Florida Affect Battery (FAB).
  
  
  METHODS
  Psychiatric subjects were recruited from a general psychiatric hospital and a forensic state hospital.
  
  
  METHODS
  A mixed group of 98 healthy men and forensic and non-forensic psychiatric subjects were investigated.
  
  
  RESULTS
  Both empathy (MET) and emotion recognition (FAB) correlated with MacCAT-CR scores. Higher cognitive empathy and good emotion recognition (compared with low empathy and emotion recognition) were associated with increased decisional capacity and higher rates of refusal to give informed consent.
  
  
  CONCLUSIONS
  This study shows an empirical relationship between decision-making and informed consent, on the one hand, and emotions and empathy on the other. While this study is exploratory and preliminary, the findings of a relationship between informed consent, emotions and empathy raise important neuroethical questions with regard to an emotional-social concept of informed consent and potential clinical implications for testing informed consent.
authors.affiliation: Department of Psychiatry, Otto-von-Guericke University, Magdeburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Supady
authors.forename: Antonie
authors.initials: A
authors.lastname: Voelkel
authors.forename: Joachim
authors.initials: J
authors.lastname: Witzel
authors.forename: Udo
authors.initials: U
authors.lastname: Gubka
authors.forename: Georg
authors.initials: G
authors.lastname: Northoff
mesh_terms: D000328:Adult; D000368:Aged; D003657:Decision Making / Q000941:ethics*; D004644:Emotions / Q000941:ethics*; D004645:Empathy; D006801:Humans; D007258:Informed Consent / Q000523:psychology*; D008297:Male; D016743:Mental Competency / Q000523:psychology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D055815:Young Adult